Chorioangioma: Causes and Treatments

Chorioangioma is a rare vascular tumour of the placenta that can have significant implications for pregnancy outcomes. Although often benign, its presence can lead to complications that necessitate careful monitoring and management.

They are the most common type of placental tumour, yet they are still relatively rare, occurring in approximately 1% of pregnancies. The tumours are made up of blood vessels and connective tissue and can vary significantly in size. Small chorioangiomas often remain asymptomatic and are incidentally discovered during routine ultrasounds. Larger tumours, however, can lead to complications such as fetal anaemia, polyhydramnios, and preterm birth.

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Chorioangioma Causes

The exact causes of chorioangioma are not well understood. Although most women with uterine atony will not have any risk factors, advanced maternal age, multiple gestations, and maternal hypertension can contribute to this complication. There may also be genetic predispositions related to the development of this condition.

Genetic and Environmental Factors

While the exact aetiology of chorioangioma remains unclear, several genetic and environmental factors may contribute to its development. Research suggests that genetic abnormalities in the placental tissue could predispose individuals to chorioangioma formation. Environmental factors, such as maternal smoking or exposure to certain chemicals, have also been implicated, although evidence is less conclusive.

Hormonal Influences

Hormonal changes during pregnancy might play a role in the development of chorioangiomas. Elevated levels of certain hormones could potentially stimulate the proliferation of vascular tissue within the placenta, contributing to tumour growth.

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Types of Chorioangioma

Chorioangiomas can be classified based on their size and potential impact on the pregnancy.

Small Chorioangiomas

These are typically less than 5 cm in diameter and asymptomatic. They are often discovered incidentally during routine prenatal ultrasounds and do not typically require intervention.

Large Chorioangiomas

Tumors larger than 5 cm are considered significant and may lead to complications. These tumours require close monitoring and, in some cases, intervention to manage associated risks.

Giant Chorioangiomas

Giant chorioangiomas exceed 10 cm in diameter and are associated with significant complications, including fetal growth restriction, hydrops fetalis, and even intrauterine fetal demise. These cases often necessitate multidisciplinary management.

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Chorioangioma Risks

Understanding these chorioangioma risks is essential for timely intervention.

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Symptoms and Diagnosis of Chorioangioma

Common Placental Chorioangioma Symptoms

The symptoms of chorioangioma depend largely on the size of the tumour. Smaller chorioangiomas are usually asymptomatic, while larger ones may present with:

Diagnosis of Chorioangioma

Chorioangiomas are typically diagnosed through prenatal ultrasound, where they appear as well-circumscribed, hypoechoic lesions within the placenta. Color Doppler imaging can further aid in diagnosis by highlighting the tumour's vascular nature. In some cases, Chorioangioma radiology, MRI may be used to assess the extent of very large tumours.

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Chorioangioma Prognosis

The prognosis of chorioangioma largely depends on the size and impact of the tumour. Small, asymptomatic chorioangiomas generally have an excellent prognosis and do not affect pregnancy outcomes. Larger tumours, however, can pose significant risks to both the mother and the fetus, necessitating careful monitoring and management throughout the pregnancy.

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Chorioangioma Treatment

Chorioangioma is a rare tumor of the placenta, and while small tumors often don’t require intervention, larger ones may need specialized care to prevent complications. Placental chorioangioma treatment focuses on protecting both the mother and baby during pregnancy, with some steps extending to treatment after birth if necessary.

Treatment During Pregnancy:

Observation and Monitoring

For small, asymptomatic chorioangiomas, regular ultrasound monitoring is typically sufficient. This allows healthcare providers to track the tumour's growth and any potential impact on the fetus.

Interventional Procedures

In cases where the tumour is large and causing complications, interventional procedures may be necessary. These can include:

Delivery Planning

The timing and mode of delivery may be influenced by the presence of a large chorioangioma. In some cases, early delivery may be warranted to prevent further complications. The mode of delivery will depend on the tumour's size, location, and effect on the placental function.

Treatment After Birth

And usually, once the baby is born, the mother does not need any additional treatment since the tumor is part of the placenta, so it is delivered with the placenta. But if the baby had anemia, strain on the heart, or other complications during pregnancy, he may need medical care.

Time of placental chorioangioma treatment should consider the degree of severity. It's important to work closely with your healthcare provider to achieve the best results for mother and baby alike.

Management of Chorioangioma in Pregnancy

Multidisciplinary Approach

Effective management of chorioangioma often requires a multidisciplinary approach involving obstetricians, neonatologists, and pediatric specialists. This team-based approach ensures comprehensive care and optimal outcomes for both the mother and the fetus.

Patient Education and Support

Educating patients about the condition, its potential complications, and the management strategies is crucial. Providing emotional support and counselling can help patients cope with the stress and uncertainty associated with a chorioangioma diagnosis.

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Complications of Chorioangioma

Understanding these complications and focusing on effective chorioangioma management is essential to ensure a safer pregnancy outcome.